Rehabilitation of lost functional vision with the Argus II retinal prosthesis.

The Argus II retinal prosthesis is the first commercially available device for restoration of vision in patients with Retinitis Pigmentosa or with similar retinal pathology who still have minimal residual native vision. The technology is able to restore vision with production of artificial visual percepts which usually are given adequate useful interpretation by the visual system in most implanted patients. The technology usually produces visual perception at the level of shape identification or better in some cases enabling in many less dependence on vision substitution devices and skills. There is no consensus among vision rehabilitation practitioners on single methods for assessments, outcome measures and training, yet there is constant progress in these areas of concern. Hence the current vision rehabilitation practice related to the implantation of the Argus II retinal prosthesis is a work in progress with many learning opportunities for all involved. All agree that implementation of this technology in clinical practice requires the combined work of a multi-disciplinary team which includes a specialized surgical team as well as a specialized rehabilitation team in order to obtain optimal results. Our own experience is presented in this paper and indicates so far that the Argus II technology is beneficial to patients and that it could be successfully managed within the Canadian heath care system.

Worldwide Argus II implantation: recommendations to optimize patient outcomes.

BACKGROUND: A position paper based on the collective experiences of Argus II Retinal Prosthesis System investigators to review strategies to optimize outcomes in patients with retinitis pigmentosa undergoing retinal prosthesis implantation. METHODS: Retinal surgeons, device programmers, and rehabilitation specialists from Europe, Canada, Middle East, and the United States were convened to the first international Argus II Investigator Meeting held in Ann Arbor, MI in March 2015. The recommendations from the collective experiences were collected. Factors associated with successful outcomes were determined. RESULTS: Factors leading to successful outcomes begin with appropriate patient selection, expectation counseling, and preoperative retinal assessment. Challenges to surgical implantation include presence of staphyloma and inadequate Tenon's capsule or conjunctiva. Modified surgical technique may reduce risks of complications such as hypotony and conjunctival erosion. Rehabilitation efforts and correlation with validated outcome measures following implantation are critical. CONCLUSIONS: Bringing together Argus II investigators allowed the identification of strategies to optimize patient outcomes. Establishing an on-line collaborative network will foster coordinated research efforts to advance outcome assessment and rehabilitation strategies.

Get up, get out, get moving: an interactive tool for education at your local school.

BACKGROUND: Childhood obesity is a growing problem in America. Orthopaedic surgeons have an opportunity to interact with communities to educate children about healthy eating and physical activity. The American Academy of Orthopedic Surgeons (AAOS) Leadership Fellows Program [1] Class of 2012 created a presentation for AAOS members to bring to local schools. The goal was to teach the children about the potential complications of childhood obesity and the benefits of healthy living. QUESTIONS/PURPOSES: We describe a program in which orthopaedic surgeons gave presentations to elementary school students about healthy eating and activity and the effects that extra weight can have on their bones. METHODS: Each of the five members of the Leadership Fellows Program [1] 2012 class (JW, EM, MP, MR, MF) presented to a school in his or her hometown. The program was presented to 210 fifth grade children throughout the country. Before and after the presentation, students took a six-question multiple-choice quiz and answers compared to assess improvement in knowledge. RESULTS: The average number of answers correct before the presentation was 4.5 out of six, and the average after the presentation was six of six. The presentations were well received, and the students and their teachers invited each presenter back the next year. CONCLUSIONS: The improvement in quiz scores demonstrated interest among the students in that they paid attention and understood the content. The children appeared enthusiastic to learn about this subject, and the schools were enthusiastic to include the curriculum.

Can one be two? A synopsis of the twinning and personhood debate.

It has been argued that the possibility of monozygotic twinning disproves the conservative position on foetal personhood that defines the foetus as a person from conception. This article will canvass arguments for and against this proposition, in order to arrive at a conclusion as to the relative strength of this finding.